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X-Factor Assessment Form

Please fill out the form.

Your Activities

Consider all the activities that you are currently involved in. What are your top choices? Listed below are spaces for your top two academic activities, your top two extra curricular activities, and your two top intellectual or personal interests outside of school activities. Examples may include debate team, playing the violin, club soccer, babysitting, collecting rare coins, reading etc.

Please provide your top two academic activities (except for required school classes).

Please don’t feel pressured to fill out all spaces if not applicable.
Please specify in the note below if choosing "other."
Selected Value: 1
1 is Lowest Priority and 5 is Highest Priority
Selected Value: 1
1 is extremely unmotivated and 5 is extremely motivated
Selected Value: 1
1 is Lowest Priority and 5 is Highest Priority
Selected Value: 1
1 is extremely unmotivated and 5 is extremely motivated

Please provide your top two extracurricular activities below.

Selected Value: 1
1 is Lowest Priority and 5 is Highest Priority
Selected Value: 1
1 is extremely unmotivated and 5 is extremely motivated
Selected Value: 1
1 is Lowest priority and 5 is Highest Priority
Selected Value: 1
1 is extremely unmotivated and 5 is extremely motivated

Please provide your top two intellectual or personal interests outside of school activities.

Selected Value: 1
1 is Lowest Priority and 5 is Highest Priority
Selected Value: 1
1 is extremely unmotivated and 5 is extremely motivated
Selected Value: 1
1 is Lowest Priority and 5 is Highest Priority
Selected Value: 1
1 is extremely unmotivated and 5 is extremely motivated